The proposed research will analyze the effects of adult mortality of a large expansion in public health insurance coverage in Costa Rica in the 1970's. A large body of research suggests that lower health care prices lead to higher health care demand, as well as improvements in child health; however, we know considerably less about effects on adult health outcomes. This investigation will evaluate the potential for exploiting regional variation in the timing of the new public insurance implementation in Costa Rica, paying special attention to controls for heterogeneity such as contemporaneous regional variation in income and employment growth. The specific aims of the project are to: (1) Gather and integrate secondary data from individual death certificates, two censuses, numerous household health and employment surveys, as well as administrative records from various government agencies; (2) Develop and estimate fixed effects models of the insurance effects on overall mortality; and (3) Explore the robustness of estimates to numerous potential sources of measurement error and unobserved heterogeneity. If the methodology is successful, future work will analyze effects on particular socioeconomic groups, and investigate the role of insurance in the epidemiological transition from infectious to chronic disease causes of death.